Xuzhou used to be a significant coal resource-based city in eastern China and a typical mining area with a high groundwater level. Prolonged underground mining activities and rapid urbanization have profoundly transformed its regional landscape pattern. Therefore, analyzing the laws of regional land use and the spatiotemporal evolution of landscape ecological security holds significant importance for regional sustainable development. Based on multi-period remote sensing data from 1990 to 2020, this study analyzed the intensity of land use changes and transformation characteristics in the eastern mining area of Xuzhou over a 30-year period. On this basis, the ecological security status of the landscape over different periods was evaluated by the Landscape Ecological Security Index. Lastly, spatial autocorrelation analysis was conducted to reveal the overall characteristics and local variations in the spatial distribution of landscape ecological security. The results indicate the following: (1) Over the course of 30 years, due to mining-induced land subsidence and water accumulation, the water area increased by 67.41%, exhibiting the highest dynamic change in land use; construction land area came next, increasing by 30.75%; cultivated land area declined the most gently. (2) From 1990 to 2010, the overall landscape ecological security status of the study area displayed a deteriorating trend, and areas with low ecological security were closely associated with mining distribution and urbanization zones. From 2010 to 2020, guided by ecological restoration plans, the fragmentation of landscape patches decreased, leading to evident improvements in local landscape ecological security. (3) The results of spatial autocorrelation analysis revealed a significant positive correlation and spatial clustering in the distribution of landscape ecological security areas. The high-high aggregation areas were mainly distributed around cultivated land, while the low-low aggregation areas were primarily distributed within the coal mining subsidence zone. Overall, coal mining subsidence and urbanization were the main factors influencing the landscape ecological security status in the highwater- level mining area. In territorial spatial planning, emphasis should be placed on the connectivity and diversity of landscapes to enhance landscape ecological security. The results offer essential information and decision support for governmental authorities and land use planners, aiming to achieve regional sustainable development.